Spinal cord injury (SCI) leads to increased anxiety and depression in as many as 60% of patients. Yet, despite extensive clinical research focused on understanding the variables influencing psychological well-being following SCI, risk factors that decrease it remain unclear. We hypothesized that excitation of the immune system, inherent to SCI, may contribute to the decrease in psychological well-being. To test this hypothesis, we used a battery of established behavioral tests to assess depression and anxiety in spinally contused rats. The behavioral tests, and subsequent statistical analyses, revealed three cohorts of subjects that displayed behavioral characteristics of 1) depression, 2) depression and anxiety, or 3) no signs of decreased psychological well-being. Subsequent molecular analyses demonstrated that the psychological cohorts differed not only in behavioral symptoms, but also in peripheral (serum) and central (hippocampi and spinal cord) levels of pro-inflammatory cytokines. Subjects exhibiting a purely depression-like profile showed higher levels of pro-inflammatory cytokines peripherally, whereas subjects exhibiting a depression- and anxiety-like profile showed higher levels of pro-inflammatory cytokines centrally (hippocampi and spinal cord). These changes in inflammation were not associated with injury severity; suggesting that the association between inflammation and the expression of behaviors characteristic of decreased psychological well-being was not confounded by differential impairments in motor ability. These data support the hypothesis that inflammatory changes are associated with decreased psychological well-being following SCI.

Mice with experimental nerve damage can display long‑lasting neuropathic pain behavior. We show here that 4 months and later after nerve injury, male but not female mice displayed telomere length (TL) reduction and p53‑mediated cellular senescence in the spinal cord, resulting in maintenance of pain and associated with decreased lifespan. Nerve injury increased the number of p53‑positive spinal cord neurons, astrocytes, and microglia, but only in microglia was the increase male‑specific, matching a robust sex specificity of TL reduction in this cell type, which has been previously implicated in male‑specific pain processing. Pain hypersensitivity was reversed by repeated intrathecal administration of a p53‑specific senolytic peptide, only in male mice and only many months after injury. Analysis of UK Biobank data revealed sex-specific relevance of this pathway in humans, featuring male‑specific genetic association of the human p53 locus ( TP53 ) with chronic pain and a male-specific effect of chronic pain on mortality. Our findings demonstrate the existence of a biological mechanism maintaining pain behavior, at least in males, occurring much later than the time span of virtually all extant preclinical studies.

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Existing assays of social interaction are suboptimal, and none measures propinquity, the tendency of rodents to maintain close physical proximity. These assays are ubiquitously performed using inbred mouse strains and mutations placed on inbred genetic backgrounds. We developed the automatable tube cooccupancy test (TCOT) based on propinquity, the tendency of freely mobile rodents to maintain close physical proximity, and assessed TCOT behavior on a variety of genotypes and social and environmental conditions. In outbred mice and rats, familiarity determined willingness to cooccupy the tube, with siblings and/or cagemates of both sexes exhibiting higher cooccupancy behavior than strangers. Subsequent testing using multiple genotypes revealed that inbred strain siblings do not cooccupy at higher rates than strangers, in marked contrast to both outbred and rederived wild mice. Mutant mouse strains with "autistic-like" phenotypes (Fmr1 −/y and Eif4e Ser209Ala) displayed significantly decreased cooccupancy.propinquity | autism | social interaction | rodent behavior | genetics

BackgroundMental health is neglected in most parts of the world. For the Indigenous Peoples of Latin America, the plight is even more severe as there are no specific mental health services designed for them altogether. Given the high importance of mental health for general health, the status quo is unacceptable. Lack of research on the subject of Indigenous Peoples' mental health means that statistics are virtually unavailable. To illustrate their mental health status, one can nonetheless point to the high rates of poverty and extreme poverty in their communities, overcrowded housing, illiteracy, and lack of basic sanitary services such as water, electricity and sewage. At the dawn of the XXI century, they remain poor, powerless, and voiceless. They remain severely excluded from mainstream society despite being the first inhabitants of this continent and being an estimated of 48 million people. This paper comments, specifically, on the limited impact of the Pan American Health Organization's mental health initiative on the Indigenous Peoples of Latin America.DiscussionThe Pan American Health Organization's sponsored workshop "Programas y Servicios de Salud Mental en Communidades Indígenas" [Mental Health Programs and Services for the Indigenous Communities] in the city of Santa Cruz, Bolivia on July16 - 18, 1998, appeared promising. However, eleven years later, no specific mental health program has been designed nor developed for the Indigenous Peoples in Latin America. This paper makes four specific recommendations for improvements in the approach of the Pan American Health Organization: (1) focus activities on what can be done; (2) build partnerships with the Indigenous Peoples; (3) consider traditional healers as essential partners in any mental health effort; and (4) conduct basic research on the mental health status of the Indigenous Peoples prior to the programming of any mental health service.SummaryThe persistent neglect of the Indigenous Peoples' mental health in Latin America raises serious concerns of moral and human rights violations. Since the Pan American Health Organization' Health of the Indigenous Peoples Initiative 16 years ago, no mental health service designed for them has yet been created.

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There is an estimated 30 million indigenous peoples in South America. Most of them live in the Andes. Regional states and governments neglect their health care needs and exclude them from the conventional Western health services in general and mental health care in particular. This review first describes this population's current situation of social exclusion, poverty and poor health. The problem of mental health care inequities in the region is illustrated through the case of the Quichua people. Indeed, for the population of over 5 million Quichua people in Ecuador, there are no psychiatric services. There are no culturally sensitive services offered in the Quichua language. The doctor–Quichua patient communication is poor and interactions are loaded with prejudice. The review provides a rationale for the Quichuas' reluctance to seek medical doctors in Ecuador. Finally, traditional healers' contribution to the mental health care of indigenous peoples is stressed, as well as their preference for a form of medical pluralism, mainly combining both traditional Quichua medicine and Western medicine. Woeful inequalities and inaccessibility to psychological and biomedical psychiatric care still widely affect the children of the sun in the Pacific Rim.

Today, deep learning (DL) algorithms are intertwined with our daily life. This subdomain of artificial intelligence (AI) technology is used to unlock your phone by only detecting your face, find the best path from work to your home or vice versa, or detect anomalies in the human cells taken for lab tests. Yet, although AI technology is helping in many fields, whether it has done so in the medical field is debatable. DL lacks reasoning; it is unable to determine the causes of events. This is especially crucial when it comes to the health care sector. At this point, computers cannot help physicians with their duties. On the contrary, they are the cause of burnout in more than half of physicians in United States. One of the causes of burnout repeatedly pointed out by physicians is the digitalization of medicine. This chapter presents some of the AI approaches that could help physicians. It also discusses the current limitations and dangers inherent to many of today’s state-of-the-art AI systems. The authors provide some ideas about the future of AI in pain medicine and psychiatry.